KYLE KETTLE (NPI# 1861092504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861092504 |
| Entity Type | Individual |
| Full Name | KYLE KETTLE |
| Credential | FNP-C |
| Practice Address |
5030 Crenshaw Rd Ste 120 Pasadena TX 77505-3141 |
| Mailing Address |
5019 Orem Rd Santa Fe TX 77517-2537 |
| Practice Telephone | 7139438229 |
| Mailing Telephone | 4097660504 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1018479 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5030 CRENSHAW RD STE 120 |
| City | PASADENA |
| State | TX |
| Zip Code | 77505-3141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545742 | Travis Jones | Pharmacist | 6767 Spencer Highway, Pasadena, TX 77505 | 2020-10-16 |
| 1952872905 | Bay Area Internal Medicine Care Pllc | Internal Medicine | Baywood Crossing Rehabilitation and Healthcare Center, 5020 Space Center Blvd., Pasadena, TX 77505 | 2018-12-16 |
| 1750851325 | Leslie Jackson | Nurse Practitioner | 7106 Spencer Highway, Pasadena, TX 77505 | 2018-11-27 |
| 1093297459 | Hieu Ngoc Minh Hutt | Occupational Therapy Assistant | 4900 East Sam Houston Pkwy S, Pasadena, TX 77505 | 2018-09-02 |
| 1780189142 | Basewave Properties, Pllc | Psychiatry & Neurology | 4808 Fairmont Pkwy, #404, Pasadena, TX 77505 | 2018-03-28 |
| 1720596141 | Lyanne Marlen Fernandez | Specialist/Technologist | 6565 Spencer Hwy Apt 1114, Pasadena, TX 77505 | 2018-01-19 |
| 1073069811 | Sng - Pasadena Dialysis Center Lp | Clinic/Center | 5040 Crenshaw Rd, Ste 200, Pasadena, TX 77505 | 2016-08-31 |
| 1235683418 | Sharon Li | Nurse Practitioner | 4001 Preston Rd #100, Pasadena, TX 77505 | 2016-08-05 |
| 1225493687 | Skkz, Inc. | Clinic/Center | 6415 Fairmont Pkwy, Ste A, Pasadena, TX 77505 | 2015-12-29 |
| 1982026530 | Aerocare Home Medical, Inc. | Durable Medical Equipment & Medical Supplies | 5041 Spencer Hwy, Suite 603, Pasadena, TX 77505 | 2014-01-16 |
| Find all providers in zip 77505 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013516640 | Heather Mekins | Nurse Practitioner | 721 Bridge Dr, Pasadena, MD 21122-4553 | 2020-10-24 |
| 1891394953 | Tammy Jean Bobbitt-gray | Nurse Practitioner | 10801 Choate Rd, Pasadena, TX 77507-1503 | 2020-10-20 |
| 1467067447 | Lizette Cabral | Nurse Practitioner | 1144 N Mentor Ave, Pasadena, CA 91104-3824 | 2020-09-15 |
| 1679188304 | Kimberly Yam | Nurse Practitioner | 1575 N Lake Ave Ste 208, Pasadena, CA 91104-2340 | 2020-09-10 |
| 1215569785 | Kristine Elizabeth Chesney | Nurse Practitioner | 1288 Holmespun Dr, Pasadena, MD 21122-2578 | 2020-02-12 |
| 1598304958 | Sophia A Phillip | Nurse Practitioner | 65 N Madison Ave Ste 800, Pasadena, CA 91101-2038 | 2020-01-03 |
| 1831748359 | Altagracia Garza | Nurse Practitioner | 908 Southmore Ave Ste 130, Pasadena, TX 77502-1100 | 2019-09-06 |
| 1548817919 | Ansela Chaluparambil | Nurse Practitioner | 3326 Watters Rd Bldg D, Pasadena, TX 77504-2053 | 2019-08-21 |
| 1972155828 | Michelle Elizabeth Hinkey | Nurse Practitioner | 8109 Ritchie Hwy # 100, Pasadena, MD 21122-6917 | 2019-07-11 |
| 1316408149 | Caitlin Demi Valverde | Nurse Practitioner | 3412 Burke Rd Ste 100, Pasadena, TX 77504 | 2019-03-26 |
| Find all providers in PASADENA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.